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Home My WebLink AboutBLDE-20-005771 Commonwealth of Official Use Only .16 Massachusetts Permit No. BLDE-20-005771 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:5/11/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertthe electrical w scribed below. "� X78 —607- Q 47q d1 Location(Street&Number) 27 GRANDVIEW DR ret' Qi N t._•A/V Owner or Tenant 'O 41A 43'" 'TR6 Telephone No. Owner's Address 1 n"lIATZQ"AAliY—E,..27 GRANDVIEW DR, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriat*t Purpose of Building Utility Authorization No. / / Existing Service Amps Volts Overhead 0 Undgrd 0 N.$. e AN ,-U New Service Amps Volts Overhead 0 Undgrd 0 No.o ITIA/`1 Number of Feeders and Ampacity 4t, I17 Location and Nature of Proposed Electrical Work: Replacement air conditioner O Completion of the following table may be waived by the p .!..4, . 'res. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of To v Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 13No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Securiq Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: WAYNE B SCHMIDT Licensee: Wayne B Schmidt Signature LIC.NO.: 33699 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:222 WILLIMANTIC DR, MARSTONS MLS MA 026481929 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 74- ?/g(-2-0 K- -.- .p,. / 8/w L'- t\/# ` Q/ / (F 5Ar ..... . ckG,. ' ro 50 • Official fcial Use OnCom+noawea oti///adsassafls • ', ,....: 02, � Permit 1CC__ 1'S?7' -= ! !r� 2aPartnanE ol.7ira Jarvieas Occupancy and Fee Ch- BOARD OF FIRE PREVENTION REGULATIONS I •ev. 1/0 ~' eave bl ,• APPLICATION 'FOR PERMIT TO PERFORM ELECTR - 4 v ; - 28 AU .° / work to be performed in accordance with the Massachusetts Electrical Code I C 527 CMR 12.'' ' G US (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .b A T City or Town of: YARMOUTH To the Inspector of Wires: r By this application the undersign give no ' e of his or her intention to perfo the electrical work described below (,, • Location(Street& umber) �V� ( (,.� 'Pr L v q��5 Owner'or Tenant rLe .ere �U(y1 ct. Telephone No. Owner's Address T '�`J irri.g Is this permit in conjunction with a bu ding permit? Yes ❑ No (Check Appropriate Box) Purpose of Building D W�\ \y‘s Utility Authorization No. Existing Service Amps I Volts Overt' - _ - 1e�ri❑, II-ndgrd❑- No,of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters _ Number of Feeders and Ampacity %-_ Lotion and Nature of Proposed Electrical Work: I I 1a-, Kq 1.Ci.C.X44t-j— (j-e' ' — • Completion of the following table may be waived by the Inspector of Wires,,siommor.4 No.of Recessed Luminaires No.of Ceti.-Susp.(Paddle)Fans o.of Total Transformers KVA No,of Luminaire Outlets No.of Hot Tubs Generators KVA No,of Luminaires Swimming Pool ' 'eve ❑ n- ❑ 'o.o 'mergency Mg 411g grnd.. crud. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches NeFilMaatikilLiars, o.of Detection and Initiating Devices No.of Ranges No.of Air Conti. 1., Tons 3 No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um a ons _'�'_ `o.of e on a ne. Totals: ""- '"-' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local Municipal Connection 0 other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No,Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin : No.of Devices ar Equivaletrt OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value oflectric l Work: (Whet;required by municipal policy.) Work to Start: 511Q, Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA E: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECKWI ONE: INSURANCE BOND 0 OTHER$,(Specify:) O ckeg's C"' f Icerci , under t'-------- -•-a-----"-.- -t_...... WAYNE SCHMIDT LIC.NO.:y,that the infonttation on this icon is true and complete. 6_� � FIRM NAME:- ELECTRICIAN 1 222 WILLIMANTIC DRIVE Licensee: ---- MARSTONS MILLS, MA 02648._.._.Signatu Ct LIC.NO.: (If applicable.ente (508)428-7747 `ne.) Address: Bus.TTel.No.• j 'Per M.G.L.C. 147,s.57-61,security work requires Department of'Public Safety"S" License: Alt.Lia.No. � �/ P OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,l hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent I,1 Signature Telephone No. [PERMIT FEE: $